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Mesenteric venous thrombosis

Mesenteric venous thrombosis is a blood clot in one or more of the major veins that drain blood from the intestine.

Causes

Mesenteric venous thrombosis is a clot that blocks blood flow in a mesenteric vein. There are two such veins through which blood leaves the intestine. The condition stops the blood circulation of the intestine and can result in damage to the intestine.

There are several diseases that can lead to mesenteric venous thrombosis. Many of the diseases cause swelling (inflammation) of the tissues surrounding the veins, and include:

Patients who have disorders that make the blood more likely to stick together (clot) have a higher risk of mesenteric venous thrombosis. Birth control pills and estrogen medicines increase risk of this condition.

Symptoms

Symptoms may include any of the following:

  • Abdominal pain, which may get worse after eating and over time
  • Bloating
  • Diarrhea
  • Fever
  • Gastrointestinal bleeding
  • Vomiting

Exams and Tests

A CT scan is the main test used to diagnose mesenteric venous thrombosis.

Other tests may include:

  • Angiogram (studying the blood flow to the intestine)
  • MRI of the abdomen
  • Ultrasound of the abdomen and mesenteric veins

Treatment

Blood thinners (most commonly heparin or related drugs) are used to treat mesenteric venous thrombosis when there is no associated bleeding. In some cases, medicine can be delivered directly into the clot to dissolve it. This procedure is called thrombolysis.

Less often, the clot is removed with a type of surgery called thrombectomy.

If you have signs and symptoms of a severe infection called peritonitis , you will usually need surgery to remove the intestine. After surgery, you may need an ileostomy (opening from the small intestine into a bag on the skin) or colostomy (an opening from the colon into the skin).

Outlook (Prognosis)

How well you do depends on the cause of the thrombosis and any damage to the intestine. Getting treatment for the cause before the intestine has died can result in a good recovery.

Possible Complications

Intestinal ischemia is a serious complication of mesenteric venous thrombosis. Some or all of the intestine dies because of poor blood supply.

When to Contact a Medical Professional

Call your health care provider if you have severe or repeated episodes of abdominal pain.

References

Brandt LJ, Feuerstadt P. Instestinal ischemia. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease Pathophysiology/Diagnosis/Management. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 114.

Singal AK, Kamath PS, Tefferi A. Mesenteric venous thrombosis. Mayo Clin Proc. 2013;88:285-294.

Updated: 5/29/2014

Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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